Northwest

Classic Boat Club Membership Application Form

Please Print and Mail This Form to Address Listed Below

Name____________________________________________________

Spouse/Partner/Children Under 18 ________________________________________________

Mailing Address_________________________________________________

City, State, Zip__________________________________________________

E-Mail Address__________________________________________________

Telephone, Home_______________________Cell Number_____________________

Boats Owned: _________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

ANNUAL DUES ARE $35.00 PER FAMILY (INCLUDING CHILDREN UNDER 18).
Memberships cover calendar year 2010. Benefits include access to members-only
areas of the club website; participation in certain members-only boating events
and workshops, and inclusion in the club’s group insurance plan, which covers
all official club events.

AMOUNT ENCLOSED: $________________

DATE: ________________________________

PAYPAL OPTION: make your PayPal payment to - nwclassicboatclub@gmail.com - please do not
forget to print this membership application and send the completed form to the address below.

OR

Print out this form, complete the information, and mail it and a check/money order to:
S. Starrfield, Treasurer, Northwest Classic Boat Club, 16826 1st Ave. S.E., Bothell, WA 98012